Difference between revisions of "Stomatitis"

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{{unfinished}}
  
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==Introduction==
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{{cat}}
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{{dog}}
  
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[[File:Stomatitis.jpg|right|200px|thumb|Stomatitis in a cat <small>''© Lisa Milella 2013''</small>]]
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==Typical Signalment==
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Stomatitis is the inflammation of the mucosa lining any structures within the mouth. This may include the lips, cheeks, [[Tongue - Anatomy & Physiology|tongue]] and [[Gingiva#Structure and Function of the Gingiva|gingiva]].
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*Both dogs and cats can develop this condition
 +
*Breeds of dog predisposed include:
 +
 
 +
<gallery>
 +
Image:Greyhound.jpg|''Greyhound'' <p> ToB 2005, WikiMedia Commons
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Image:Maltese.jpg|''Maltese'' <p> Sannse 2003, WikiMedia Commons
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Image:Cavalier_king_charles_spaniel.jpg|''Cavalier King Charles Spaniel'' <p> Andreweatock 2009, WikiMedia Commons
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Image:Miniature_schnauzer.jpg|''Miniature Schnauzer'' <p> MagnusK 2006, WikiMedia Commons
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Image:labrador.jpg|''Retriever (Labrador)'' <p> Elf 2004, WikiMedia Commons
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</gallery>
 +
 
 +
==Description==
 +
Stomatitis is the inflammation of the mucosa lining any structures within the mouth. This may include the lips, cheeks, tongue and gingiva.
  
 
Several different types of stomatitis have been described in the dog:
 
Several different types of stomatitis have been described in the dog:
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Chronic ulcerative paradental stomatitis which is seen on the buccal mucosa that overlie the teeth, especially in the area of the maxillary canine tooth, fourth premolar and the lateral edge of the tongue. Severe ulceration can occur together with gingival recession.
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*'''Chronic ulcerative paradental stomatitis''' - Seen on the buccal mucosa that overlie the teeth, especially in the area of the maxillary canine tooth, fourth premolar and the lateral edge of the tongue. Severe ulceration can occur together with gingival recession.
  
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Ulcerative stomatitis which presents as ulcerations on the margins of the tongue that are common together with a secondary lip-fold dermatitis due to excessive salivation.
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*'''Ulcerative stomatitis''' - Ulcerations on the margins of the tongue are common together with a secondary lip-fold dermatitis due to excessive salivation.
  
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Necrotizing stomatitis which is a very painful condition in dogs that may be caused by opportunistic invasion of normal oral flora. Suspected causative organisms include [[Fusobacterium necrophorum|''Fusobacterium'']] and [[:Category:Spirochaetes|spirochaetes]]. Invasion of these organisms is thought to be associated with reduced host resistance.
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*'''Necrotizing stomatitis''' - A very painful condition in dogs that may be caused by opportunistic invasion of normal oral flora. Suspected causative organisms include [[Fusobacterium|''Fusobacterium'']] and [[:Category:Spirochaetes|spirochaetes]]. Invasion of these organisms is thought to be associated with reduced host resistance.
  
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Uraemic stomatitis which occurs as a result of [[uraemia]] due to renal disease. Severe stomatitis and ulceration of the oral mucosa as well as the margins of the tongue are seen with this condition. The lesions occur due to the bacterial degradation of urea to form ammonia together with dehydration and drying of the oral mucosa that results from renal disease.
+
*'''Uraemic stomatitis''' - Occurs as a result of uraemia due to renal disease. Severe stomatitis and ulceration of the oral mucosa as well as the margins of the tongue are seen with this condition. The lesions occur due to the bacterial degradation of urea to form ammonia together with dehydration and drying of the oral mucosa that results from renal disease.
  
 
Stomatitis in the cat:
 
Stomatitis in the cat:
  
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Only one form of the disease which is [[Feline Lymphoplasmacytic Gingivitis Stomatitis Complex|Feline lymphoplasmacytic gingivitis stomatitis complex]].
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*[[Feline Lymphoplasmacytic Gingivitis Stomatitis Complex|Feline lymphoplasmacytic gingivitis stomatitis complex ]]
  
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==Signalment==
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==Diagnosis==
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Both dogs and cats can develop this condition.
 
−
Breeds of dog predisposed include the Greyhound, Maltese, Cavalier King Charles, Miniature Schnauzer and Labrador Retriever.
 
  
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==Diagnosis==
 
 
===Clinical Signs===
 
===Clinical Signs===
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Include severe halitosis, hypersalivation, thick, ropey saliva, anorexia caused by pain, malaise, pyrexia, weight loss and ulceration and bleeding of the gingiva.
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*severe halitosis
 +
*hypersalivation
 +
*thick, ropey saliva
 +
*anorexia caused by pain
 +
*malaise
 +
*febrile
 +
*weight loss
 +
*ulceration and bleeding of the gingiva.
  
 
===Oral Examination===
 
===Oral Examination===
Line 35: Line 53:
  
 
===Biopsy===
 
===Biopsy===
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Often indicated to rule out other diseases such as [[Pemphigus|pemphigus]] or other immunopathies.
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Often indicated to rule out other diseases such as [[Skin Immunologic - Pathology#Pemphigus|pemphigus]] or other immunopathies.
−
 
 
−
===Pathology===
 
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Starts as hyperaemia and oedema of the [[Tongue - Anatomy & Physiology|tongue]] or pharynx with mucoid exudate on the surface.
 
−
Lymphoid follicles on the [[Soft Palate|soft palate]] may enlarge and proliferate.
 
−
Often see white spots due to epithelial hyperplasia and increased mucous secretion, these can be scraped off to leave ordinary mucosa underneath. 
 
  
 
==Treatment==
 
==Treatment==
 
Treatment is both symptomatic to control the clinical signs as well as specific to the cause of the condition. The underlying cause should be sought and treated appropriately.
 
Treatment is both symptomatic to control the clinical signs as well as specific to the cause of the condition. The underlying cause should be sought and treated appropriately.
  
−
Thorough teeth cleaning is necessary as well as systemic [[Antibiotics|antibiotics]] (effective against aeobes and anaerobes).
+
*Thorough teeth cleaning
−
Oral rinses such as chlorhexidine may also be useful.
+
*Systemic [[Antibiotics|antibiotics]] (effective against aeobes and anaerobes)
−
[[Steroids|Corticosteriods]] have been suggested with cases of chronic ulcerative paradental stomatitis.
+
*Oral rinses such as chlorhexidine
−
Diet modification in cases of renal disease to reduce blood urea levels.
+
*[[Steroids|Corticosteriods]] have been suggested with cases of chronic ulcerative paradental stomatitis.
−
Tooth extraction in the most severely affected area has been suggested.
+
*Diet modification in cases of renal disease to reduce blood urea levels.
−
Resistent lesions in cats have been shown to respond to bovine lactoferrin in some cases.
+
*Tooth extraction in the most severely affected area has been suggested.
 +
*Resistent lesions in cats have been shown to respond to Bovine lactoferrin in some cases.
  
 
==Prognosis==
 
==Prognosis==
 
Depends on the underlying cause.
 
Depends on the underlying cause.
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{{Learning
 
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|Vetstream = [https://www.vetstream.com/canis/Content/Disease/dis00627.asp, Ulcerative stomatitis]
 
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|flashcards = [[Veterinary Dentistry Q&A 17]]
 
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|literature search = [http://www.cabdirect.org/search.html?q=title:(%22Stomatitis%22)&fq=sc:%22ve%22 Stomatitis publications]
 
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[http://www.cabdirect.org/search.html?q=title:(%22stomatitis%22)+AND+od:(dogs)  Stomatitis in dogs publications]
 
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[http://www.cabdirect.org/search.html?q=title:(%22stomatitis%22)+AND+od:(cats) Stomatitis in cats publications]
 
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[http://www.cabdirect.org/search.html?q=title:(%22stomatitis%22)+AND+od:(horses) Stomatitis in horses publications]
 
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[http://www.cabdirect.org/search.html?q=title:(%22stomatitis%22)+AND+od:(cattle) Stomatitis in cattle publications]
 
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[http://www.cabdirect.org/search.html?q=title:(%22stomatitis%22)+AND+od:(sheep) Stomatitis in sheep publications]
 
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[http://www.cabdirect.org/search.html?q=title:(%22stomatitis%22)+AND+od:(pigs) Stomatitis in pigs publications]
 
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}}
 
  
 
==References==
 
==References==
  
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Merck & Co (2008) '''The Merck Veterinary Manual'''
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*Merck & Co (2008) '''The Merck Veterinary Manual'''
  
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Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''
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*Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''
  
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Tutt, C., Deeprose, J. and Crossley, D. (2007) '''BSAVA Manual of Canine and Feline Dentistry (3rd Edition)''' ''BSAVA''
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*Tutt, C., Deeprose, J. and Crossley, D. (2007) '''BSAVA Manual of Canine and Feline Dentistry (3rd Edition)''' ''BSAVA''
  
 +
==From Pathology==
  
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{{review}}
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Catarrhal Stomatitis
  
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==Webinars==
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*Non-specific, general stomatitis
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<rss max="10" highlight="none">https://www.thewebinarvet.com/gastroenterology-and-nutrition/webinars/feed</rss>
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===Pathology===
 +
*Starts as hyperaemia and oedema of [[Oral Cavity - Tongue - Anatomy & Physiology|tongue]] or pharynx with mucoid exudate on surface.
 +
*Lymphoid follicles on [[Soft Palate - Anatomy & Physiology|soft palate]] may enlarge and proliferate.  
 +
*Often see white spots due to epithelial hyperplasia and increased mucous secretion.
 +
**(can be scraped off to leave ordinary mucosa underneath). 
 +
*May produce bad smell. 
 +
*Resolves normally if not secondarily infected.
  
 +
===Pathogenesis===
 +
*May be caused by:
 +
**Low grade [[:Category:Streptococcus species|streptococcal]] infection
 +
**Ingestion of toxins
 +
**Result of other more systemic diseases
 
[[Category:Oral_Cavity_and_Gingiva_-_Pathology]]
 
[[Category:Oral_Cavity_and_Gingiva_-_Pathology]]
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[[Category:Oral Diseases - Cat]][[Category:Oral Diseases - Dog]]
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[[Category:To_Do_-_Clinical]]
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[[Category:Expert_Review - Small Animal]]
 
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[[Category:Periodontal Conditions]]
 

Revision as of 20:30, 22 July 2010


 This article is still under construction.


Category:WikiClinical FelineCow
Category:WikiClinical CanineCow

Typical Signalment

  • Both dogs and cats can develop this condition
  • Breeds of dog predisposed include:
  • Greyhound

    ToB 2005, WikiMedia Commons

  • Maltese

    Sannse 2003, WikiMedia Commons

  • Cavalier King Charles Spaniel

    Andreweatock 2009, WikiMedia Commons

  • Miniature Schnauzer

    MagnusK 2006, WikiMedia Commons

  • Retriever (Labrador)

    Elf 2004, WikiMedia Commons

Description

Stomatitis is the inflammation of the mucosa lining any structures within the mouth. This may include the lips, cheeks, tongue and gingiva.

Several different types of stomatitis have been described in the dog:

  • Chronic ulcerative paradental stomatitis - Seen on the buccal mucosa that overlie the teeth, especially in the area of the maxillary canine tooth, fourth premolar and the lateral edge of the tongue. Severe ulceration can occur together with gingival recession.
  • Ulcerative stomatitis - Ulcerations on the margins of the tongue are common together with a secondary lip-fold dermatitis due to excessive salivation.
  • Necrotizing stomatitis - A very painful condition in dogs that may be caused by opportunistic invasion of normal oral flora. Suspected causative organisms include Fusobacterium and spirochaetes. Invasion of these organisms is thought to be associated with reduced host resistance.
  • Uraemic stomatitis - Occurs as a result of uraemia due to renal disease. Severe stomatitis and ulceration of the oral mucosa as well as the margins of the tongue are seen with this condition. The lesions occur due to the bacterial degradation of urea to form ammonia together with dehydration and drying of the oral mucosa that results from renal disease.

Stomatitis in the cat:

Diagnosis

Clinical Signs

  • severe halitosis
  • hypersalivation
  • thick, ropey saliva
  • anorexia caused by pain
  • malaise
  • febrile
  • weight loss
  • ulceration and bleeding of the gingiva.

Oral Examination

A thorough oral examination under general anaesthesia is often required to aid the diagnosis. Diagnosis is usually made by gross visualisation of the lesions. The mandibular lymph nodes may also be enlarged.

Laboratory Tests

Clinical pathology may be carried out to assess renal function in the case of uraemic stomatitis. Culture and sensitivity tests may be required to aid diagnosis and enable specific treatment.

Biopsy

Often indicated to rule out other diseases such as pemphigus or other immunopathies.

Treatment

Treatment is both symptomatic to control the clinical signs as well as specific to the cause of the condition. The underlying cause should be sought and treated appropriately.

  • Thorough teeth cleaning
  • Systemic antibiotics (effective against aeobes and anaerobes)
  • Oral rinses such as chlorhexidine
  • Corticosteriods have been suggested with cases of chronic ulcerative paradental stomatitis.
  • Diet modification in cases of renal disease to reduce blood urea levels.
  • Tooth extraction in the most severely affected area has been suggested.
  • Resistent lesions in cats have been shown to respond to Bovine lactoferrin in some cases.

Prognosis

Depends on the underlying cause.

References

  • Merck & Co (2008) The Merck Veterinary Manual
  • Nelson, R.W. and Couto, C.G. (2009) Small Animal Internal Medicine (Fourth Edition) Mosby Elsevier
  • Tutt, C., Deeprose, J. and Crossley, D. (2007) BSAVA Manual of Canine and Feline Dentistry (3rd Edition) BSAVA

From Pathology

Catarrhal Stomatitis

  • Non-specific, general stomatitis

Pathology

  • Starts as hyperaemia and oedema of tongue or pharynx with mucoid exudate on surface.
  • Lymphoid follicles on soft palate may enlarge and proliferate.
  • Often see white spots due to epithelial hyperplasia and increased mucous secretion.
    • (can be scraped off to leave ordinary mucosa underneath).
  • May produce bad smell.
  • Resolves normally if not secondarily infected.

Pathogenesis

  • May be caused by:
    • Low grade streptococcal infection
    • Ingestion of toxins
    • Result of other more systemic diseases
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